15th August 2016

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Ed Smith
Chair of Not-Monitor, or whatever it's called.  In conversation with Roy L
Good conversation, networking and a glass of wine.  What's not to like!  Tickets are slipping away!  Get yours.
Bring it on?
News and Comment from Roy Lilley
Here we go again.  The junior doctors want to have more strikes.
Should we beg them not to?  Should we wrap our arms around them and plead.  Should we bribe them, fete them, ask them nicely to desist or say; 'bring it on'.
I covered the last strikes in detail and gave the JDs air-time.  Here, here, here, here, here, here and
.  And a lot more here.  I was broadly 
sympathetic and pressed everyone to keep talking... 
but their strategy was a dog's breakfast and 
communications a disaster.  

Many JDs I spoke to hadn't read relevant documents and didn't really understand why they were striking.  It had a 'student protest' feel about it.
Now, let's think...
The BMA constitution requires their Council to approve strike action.  In the last round of the dispute they put the  'final' version of the contract before the JDs in the context it should be accepted.
In theory that means they'd find it hard to consent to further strike action as the implication is, they regard the terms already on offer agreeable.
If the BMA council do that, it will invite a split in the Union and if there's any one with any integrity in membership... some high-placed resignations.
If they don't... see preceding paragraph!
Whatever we think of the JD's case, their position is totally undermined by the astonishing leak of emails at the end of the last punch up, revealing their secret strategy was to drag-out the dispute for as long as possible.  It was political, wise up.
The fact that one way or another 200,000 patients were either inconvenienced, messed about or parked in the system is not something they appear bothered about.
The profession of doctoring is not what it used to be.
What of the Trusts?  I'm hearing a significant chunk of them have not got adequate monitoring arrangements and Guardians in place.  In some cases it is because the JDs have been awkward and in other cases because the Trusts have been dilatory.
These arrangements and the fact that the success of the peace process hinges on their being in place means some Trust Boards need a kicking.  The Jim Reaper better get busy.
What about the Tinkerman?  Given the parlous state of  NHS performance, finances and morale, driving the weekend-thing will make him look truly ridiculous.
He has to deliver 7-day services, whatever that means, in time for the 2020 election.  His best move is to back-off and leave it to the Reaper to deliver.
It may come as difficult news for him but the Tinkerman, sorry to have to say this, is toxic.  I'm pleased he has stayed in place because stability is important right now and the last thing we need is a new Secretary of State with another bag of daft ideas.
However, he can only make things worse.  His job is to shut up, be patient, visit places and smile.
NHS employers?  They have to be a lot more transparent.  I think they have a good story to tell about how hard they tried to fix this last time.  They need to make it clear; if they get back into talks they'll publish minutes of every meeting with the BMA at 11pm on the day they occur.  Let's all see who is in-good-faith.
The public?  They were beguiled last time.  Chants of 'not-fair' and 'not-safe' won't wash now.  Expect the JDs claims to be parked alongside Boris' bus.
Once the public have family members whose wellbeing is touched by the dispute, you can forget picket line invites to 'honk for support', JDs' will be running for cover as the passing-disgruntled throw things at them.  If the public turn, so will the press.
Expect an influx of EU doctors.  Whilst they can still come, Trusts will be recruiting.  The Vienna Convention and needs-must will keep them here.
The JDs?  They will split their Union;
  • be shown, in many cases to have sabotaged local Guardian arrangement;
  • had a disingenuous agenda during the last strike and some probably lied to the public and to members;
  • are ruining the profession's reputation and some senior doctors are telling me they won't put up with it again;
  • kicking the NHS at its most vulnerable and difficult time since 1948;
  • being politically motivated, using the NHS, caught in the cross fire, in a wider political agenda;
  • look petulant and selfish;
  • have no crisp definable narrative about a working environment that the vast majority of working people would recognise as a problem;
  • irritate, annoy and finally infuriate the pubic, lose support...
  • and fight amongst themselves.
A strike?  What should we say to the JDs? 
Please stop... or bring it on? 
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26th Sept Kings Fund  5.30pm.
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This is what I'm hearing;
if you know different,
tell me here
>>  I'm hearing - out-going President of the RCEM, Clifford Mann will become NHSE lead for accident and emergency improvement plan. Interesting appointment as he has been a vociferous critic of the DH et-al.
>>  I'm hearing - Pennine Acute is to be laebled inadequate by the CQC.  My message; ignore it.  Do the best with what you've got.  No one has enough nurses.  It's the planning process that is inadequate, not you.
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